Doctor of Psychology (PsyD) Theses and Dissertations
3-1-2017
Being, doing, and play: A theoretical and clinical
exploration
Nathan A. Haskell
This research is a product of the Doctor of Psychology (PsyD) program at George Fox University.Find out moreabout the program.
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Recommended Citation
Being, doing, and play: A theoretical and clinical exploration
by
Nathan Haskell
Presented to the Faculty of the
Graduate Department of Clinical Psychology
George Fox University
in partial fulfillment
of the requirements for the degree of
Doctor of Psychology
in Clinical Psychology
Newberg, Oregon
Being, doing, and play: A theoretical and clinical exploration
Nathan Haskell
Graduate Department of Clinical Psychology at
George Fox University
Newberg, Oregon
Abstract
This paper explores the metonymy of the following aphorism, delivered by Winnicott in a 1967
lecture: “From being comes doing, but there can be no do before be.” (1970, p. 25, emphasis in
original). This aphorism has been little discussed or explored in the literature, but Winnicott
articulated similar ideas in his more academic papers (e.g., 1965, 1970). These similar
communications about being and doing will be examined alongside more contemporary thinking
about the ideas to which Winnicott alludes in this aphorism; works by Benjamin (1988) and
Akhtar (2000) in particular will be brought to bear on the subject. Two case studies will then be
discussed, in order to examine the clinical implications of the theoretical discussion. Ultimately,
such exploration will substantiate the claim that, through the metonymy of being and doing,
Winnicott was alluding to a “statement of human nature” that he published just 3 years later
(1970, p. 2). Winnicott’s own concept of play will then be posited as a critical, third element
comprising “the life of a human being,” which will serve to situate the discussion within a
Table of Contents
Approval Page ... ii
Abstract ... iii
Chapter 1: Introduction ...1
Being:Doing :: Female:Male?...2
Chapter 2: A Relational Focus?...5
Being:Doing :: Homepathic:Disruptive...5
Being:Doing:Play...8
Ms. B...10
Discussion...11
Mr. D...13
Discussion...15
Chapter 3: Conclusion...17
Final Thoughts on Play...19
References...22
Chapter 1
Introduction
In a talk given to the Royal Medico-Psychological Association in 1967, Winnicott
delivered this evocative aphorism: “From being comes doing, but there can be no do before be.”
(1970, p. 25, emphasis in original). The compelling metonymy of this line has been little
discussed or explored in the literature. Perhaps this is because Winnicott delivered the line in one
of his less-academic publications. Despite this informal context, the line is delivered in
trademark Winnicottian style, which Ogden (1986) describes as involving “deceptively simple,
highly evocative metaphorical language” (p. 206). The line’s ostensible simplicity make it an
evocative line indeed; it seems to invite us more thoroughly to investigate Winnicott’s thinking
about being and doing.
This paper attempts to respond to that invitation. Moreover, it attempts to avoid what
Ogden (1986) notes as a common effect of Winnicott’s use of language: namely, a sense of being
admired but ultimately “insulated from systematic exploration, modification, and extension” (p.
206). Accordingly, this paper attempts to explore and to extend Winnicott’s communication
about being and doing. Specifically, the metonymy of “being” and “doing”will be unpacked,
contextualized relationally, and extended to the clinical situation. It will also be an attempt at
synthesis, integrating the ideas contained within Winnicott’s aphorism with the ideas of
Benjamin (1988) and Akhtar (2000), and with Winnicott’s own ideas about play, transitional
Being:Doing :: Female:Male?
The first place we might turn to in exploring this aphorism about being and doing is to
Winnicott’s more academic communications of this idea. He penned a similar line in Chapter 4
of Playing and Reality: “After being – doing and being done to. But first, being” (1970, p. 85). In
this same chapter, Winnicott introduces the idea of “male and female elements,” and associates
them with the verbal nouns of being and doing: “The object-relating of the male element does
while the female element (in males and females) is” (p. 81, emphasis in original).
It seems clear, then, that Winnicott associates being with a relational style characteristic
of the female gender, and doing with a relational style characteristic of male gender. What these
gendered relational styles are presumed to be is still unclear, however. Moreover, such ossified,
even prescriptive categorization may well be considered problematic. Recent dialogue about the
vicissitudes and the performativity of gender (e.g., Butler, 1995; Phillips, 1995) provide a
compelling rationale for such concern. If Winnicott’s thinking about being and doing is grounded
in a problematic politics of sex, gender, and power, does the entire constellation of thought lose
its merit? Gerson (2004) has read such criticism into Winnicott.
However, one of the field’s preeminent feminist thinkers has interpreted Winnicott’s
seemingly sexist associations in a more positive light: Benjamin (1988) asserts that, “If feminists
are not to ignore the importance of the body in shaping our mental representations, they must
read [metaphors of spatial, anatomical representation] differently. Winnicott offered the
beginning of such a different reading.” (p. 127). This is to say that when Winnicott (1970) writes
that “the pure female element establishes … the experience of being” (p. 80), Benjamin bears
containment to a considerable degree, she concludes that Winnicott uses being metonymically, to
stand in for “the capacity to develop an inside, to be a container” – in short, for “the ability to
hold oneself,” to feel that one is an authentically alive self (Winnicott, 1988, p. 127-128).
Benjamin (1988) also interprets Winnicott’s association of doing with “the male
element,” though not through the use of physical imagery. Instead, she substantiates her
interpretation with findings from an infant observation study: “Fathers play with infants differs
from mothers: it is more stimulating and novel, less soothing and accurately tuned” (Yogman,
1982, as cited in Benjamin, 1988,p. 102). Through this study, Benjamin reifies Winnicott’s
“male element” as the active, exciting interaction of fathers, and active, exciting interaction thus
becomes the substance of the Winnicottian metonymy doing. Benjamin also asserts that “the
father is perceived as representing the outside world,” adding an element of alterity to what we
can hear in Winnicott’s doing, just as she added a holding of the internal self to what we can hear
in his being (p. 100).
To summarize what has been said so far, Winnicott (1970) associated being with a female
element and doing with a male element. Such gendered associations are the extent of Winnicott’s
explication of these metonymic terms, however, and the field has done little to interpret this
metonymy.1 Benjamin (1988) unpacked this metonymy, interpreting being as a matter of
containment/holding of the self (through an analysis of the physical imagery of Winnicott’s
“female element”) and she interpreted doing as a matter of exciting alterity (through observation
1 The concept of being has received more attentionthan doing (e.g., Green, 2010), but both terms remain relatively
unexplored. A comparison of being and having is more common in Lacanian discourse. Others might find the notion of being itselfto be fallacious – “There is only doing,” they might claim, “in that personality and selfhood are meaningless terms outside of active relations with others.” Perhaps becoming might be argued to be a more accurate linguistic placeholder.
of fathers’ interactions with infants). These interpretations are helpful in that they clarify
Winnicott’s “deceptively simple, highly evocative” language (Ogden, 1986, p. 206). However,
these interpretations retain the problematically gender-bound circumscription of Winnicott’s
original communications. An interpretation that can account for the way in which a capacity for
[a held, contained, inner-sense of being in one’s self] can come from male caregivers, and for the
way in which a capacity for [active, excitatory, externally-oriented doing with others] can come
Chapter 2
A Relational Focus
Being:Doing :: Homepathic:Disruptive
Akhtar (2000) cites a child observation study (Herzog, 1984) about the relational styles of
caregivers, which closely resembles the study (Yogman, 1982) that Benjamin (1988) used in her
discussion of relational styles. Like the study cited by Benjamin, Herzog observed a marked
difference in the way mothers and fathers tend to relate with children. He identified these two
relational styles as homeostatic and disruptive attunement. Homeostatic attunement is defined as
the caregiver joining the toddler in her or his play. This type of relating was more commonly
observed in mothers. Disruptive attunement, on the other hand, is defined as interaction in which
the caregiver cajoles the toddler into joiningthe caregiver in a new activity. This was more
commonly observed in fathers.
These observations, even more than the observations cited by Benjamin, allow us to
enrich Winnicott’s discourse on being and doing. Winnicott spoke of being as corresponding to
female object-relating, and Herzog’s study identifies homeostatic attunement as the characteristic
female/maternal interaction. This pairing allows us to understand being,and secure selfhood, as
facilitated by homeostatic attunement, rather than as something provided specifically or
exclusively by mothers.2 Likewise, Herzog’s study finds that disruptive attunement provides
important contrast to homeostatic attunement. We can thus understand doing – healthy
2 Perhaps “selfhood” is not a meaningful concept, as argued by Lacan, Mitchell (1991), and many eastern thinkers
engagement with alterity – not as something specifically associated with male caregivers, but as
a faculty facilitated by interactions that provide disruptive attunement.
The language that Herzog used – “homeostatic” and “disruptive”– is significant because
it highlights not the gender of the caregiver, but the mannerof interaction. Akhtar’s (2000)
presentation of Herzog’s study is significant in that it expands this discussion outside of
caregiving interaction and brings it to bear on a discussion of modes of clinical intervention;
homeostatic and disruptive attunement are seen as relational positions that a clinician (regardless
of gender or sex) can take. The benefits of this broader, more relational conceptualization will be
expanded upon in the discussion of clinical material that will conclude this paper.
At this time, I will present an informal observation of homeostatic and disruptive
attunement, which I chanced upon while preparing this paper. I hope that doing so will
demonstrate how our understanding of Winnicott’s being and doing is enriched by a more
relationally oriented perspective:
I was hiking out in the Columbia River Gorge months ago when, at one point in the
trail, the densely-wooded hillside opened out into an expansive view of the
eponymous gorge. At this point, I heard a young child strapped to his mother’s back
exclaim, “Mommy, Daddy, look at the hole!” For a moment, both his parents were
puzzled and asked the boy to clarify what “hole” he was referring to. Then it
dawned on them that, with the word “hole,” the boy was referring to the vast gorge
that had come into view. The boy’s mother was quick to accommodate to his
language/perception, affirming that it was indeed a big “hole.” [She was exampling
hand, took a different tack: he explained in a firm voice that the “hole” in question
was actually a “gorge.” [The father was exampling disruptive attunement, obliging
the boy to join him in something new – in this case, identifying linguistic and
geographic distinctions.]
In reflecting on this vignette, the gender of either parent is unimportant. What is worthy
of note is the function of each parents’ interaction, that is, the way in which selfhood and being
are shored up by homeostatic attunement (which the mother, in this case, happened to provide),
while active doing – engagement with alterity – is encouraged by disruptive attunement (which
the father here happened to provide).
The example helps bring these relational functions into focus. In the mother’s
homeostatic response (“Yes, that is a big holeisn’t it?”), the message that the child may receive
is something like, I see you and confirm you in the self that you are, just as you are right now.
The child is offered an experience of “continuity of being” (Winnicott, 1965, p. 54), and need do
nothing in response but go-on-being. In the father’s disruptive response (“That’s not a hole,
that’s a gorge!”), the child is confronted with something outside himself and has the option of
engaging with new material in an active way. Engaging with this new material would involve the
child actively engaging his own cognitive processes. Responding to such attunement might also
include active acknowledgement of what confronts him, maybe in the form of a question (e.g.,
“What’s a gorge?”).
We can imagine how differences in such factors as temperament, caregiver(s), and social
and developmental history would impact a child’s (or a patient’s) pulling for or receiving these
this point to some degree. For now, the most significant observations to be made are to the links
created above, between [being, homeostatic attunement, and the shoring up of the self,] and
[doing, disruptive attunement, and engagement with alterity]. This linking is significant because,
in using these links to unpack Winnicott’s metonymy, we have an immediate grasp of the
relational dynamics at hand, without having to stretch the connotations of “the male/female
element” to the situation.
Winnicott no doubt meant to contextualize being and doing as modes of relating.
However, his sole explicit communication about these terms was as the correlates of male and
female elements, upon which he did not elaborate. And unfortunately, although Benjamin (1988)
engages in an enlightening discussion of the subject, her discussion remains excessively
correlated with a gendered situation. Thus, Akhtar’s (2000) paper – which presents the
non-gendered language of homeostatic vs. disruptive attunement in a manner that parallel’s
Winnicott’s phrasing (“From being comes doing …”) – helps us read being and doing as
relational functions with significant clinical relevance.
Being:Doing:Play
Before proceeding with clinical discussion, the concept of play needs to be brought into
this discourse. Play, and the corresponding concepts of transitional space and transitional
objects, were central to Winnicott’s thinking. Accordingly, our exploration of Winnicottian
thinking benefits from considering being and doing in conjunction with play.
Winnicott understood play to be of critical importance because he viewed it as the “third
part of the life of a human being,” in a tripartite “statement of human nature” that he put forward
“play” at this preliminary point in his exposition – here he uses the word “experiencing” (p. 2,
emphasis in original). However, his descriptions of experiencing as an “intermediate area
between the subjective and the objectively perceived,” straddling “inner reality and external life”
correspond to his later elaborations upon the concept of play as “not inside ... nor … outside” (p.
2-3; p. 41). As for the other two parts of “the life of a human being,” Winnicott speaks of (a)
“inner reality” and (b) “interpersonal” – that is, external – reality as comprising the other two
parts of human nature, on either side of the “intermediate” space of (c) experiencing/play (p. 2).
There is an interesting inconsistency to Winnicott’s language about these three “parts of
the life of a human being” It concerns his use of verbal nouns (adverbs), which Winnicott found
particularly significant as evidenced by his frequent use of them (e.g., “holding,” “dreaming,
fantasying, and living,” “object-relating,” etc.). So we may note with interest that in this grand
“statement of human nature,” Winnnicott supplies verbal nouns – “experiencing” and later
“playing” – to denote “the third part of the life of a human being.” But he does not supply verbal
nouns for either of the other two parts: “inner” and “external” reality.
I submit that (a) being and (b) doing might well be read as the verbal nouns that
correspond to the first two parts of Winnicott’s “statement of human nature,” that is, to (a) inner
and (b) external reality. In other words, being can be read as the verb-al expression of a secure
sense of inner reality, and doing can read as the verb-al expression of healthy engagement with
external reality. We can, in short, posit being and doing as two of the three vital spaces in which
Winnicott’s saw personhood taking place.
Reading being and doing as central components of Winnicott’s thinking about human
to propose when his words are taken at face value (p. 81). Perhaps, like Akhtar (2000), he meant
to introduce being and doing as relational functions which consolidate a sense of self or invite
engagement with alterity, respectively. If this reading is possible from within Winnicott’s
oeuvre, then being, doing, and play can be read as a unified concept. This conception may have
significant clinical relevance. I will discuss this reading and this possibility through two case
studies.
Ms. B
Ms. B was what diagnosticians could call “clinically depressed.” She almost never left
the house except to meet with me. At these meetings, she was a heavy presence to sit with, as she
spoke of dysthymia and lethargy in a weary tone. Her entry into the room matched the cadence
of her voice: slow and resigned. Ms. B would sit upon the couch almost motionless, feet firmly
planted in front of her, for the duration of the session. She spoke in discouraged, plaintive tones
about the neglectful, abusive relationships she had experienced, first with her mother and then
with multiple husbands. She had no father to speak of. Overall, Ms. B felt definitively present,
but more as an immoveable rock than as a dynamic presence.
I soon began to feel frozen, turned to stone myself by these sessions. I felt I could not
move, almost could not open my mouth. I began to cast about for any sort of active intervention
that might counter the inexorable, gravitational pull Ms. B’s mass was having on me. Some of
this casting about took place in a group supervision session. The behest of this group’s staunchly
behavioral supervisor was enticing, so I began to introduce some behavioral activation in my
Just a few weeks into this kind of work, Ms. B began to experience stirrings of vital
activity that went above and beyond any of the simple activities we had talked about her
attempting. Entirely of her own accord, she proposed to her partner that they attend a showing of
the exciting, visually stimulating movie Gravity in IMAX. She enjoyed herself immensely, and
did not experience any of the agoraphobic panic she constantly defended against. The following
weeks found Ms. B making plans to go to the mall or department store, and to clean her house,
all of which she carried out to her great delight. It was astonishing. Has she not only
consolidated a stable sense of self, I asked myself, but also moved into good relations with the
external world, all within a couple months?Is she, like theprotagonist in Gravity, prepared to
become untethered and to actively propel herself through the vast abyss all around her?
However, Ms. B soon received a call from her mother’s foster home informing her that
her mother’s health had taken a turn for the worse, and she likely only had a few weeks or
months left to live. Following this news, all the movement that Ms. B was making into the
outside world came to an abrupt halt. She became even more housebound than before. She now
found herself rooted not just in the house but, for most hours of the day and night, in her
armchair in front of the TV, food wrappers piling up all around her. As we talked about this new
development, I learned that armchair-in-front-of-the-TV-all-day-and-all-night had been the
customary position of Ms. B’s mother, as well.
Discussion. There are, of course, numerous valid ways to read this case. As Mitchell
(1998) reminds us, “Theories are not facts, observations, or descriptions – they are organizational
schemes, ways of arranging and shaping facts, observations, and descriptions” (p. 15). With
and play, to see what clinical relevance we may glean from this proposed interpretation of
theory.
Winnicott described a sense of being as prerequisite to the active engagement with
alterity that he spoke of through the metonymy of doing (“From being comes doing…”). Ms. B
seemed capable only of being, and only tenuously at that. It was as if her sense of being was so
insubstantial that she feared it would dissipate without the support of a holding, containing
environment (e.g., the walls of her home or of my office). As long as she was receiving the
homeostatic attunement (the messaging that she was safe and accepted just as she was) that these
holding environments provided, she was secure. But it was as if she feared that, without walls to
reinforce her being, she would be adrift in a vacuum, like the astronauts in Gravity.
As I began to introduce a new kind of relating in our sessions (i.e. disruptive attunement,
the behavioral activation), Ms. B began to seem eager to engage with the outside world. She
began to feel capable of propelling herself through the void, to some extent. Maybe this was the
first time a significant attachment figure had invited her to do things – indeed, it is hard to
imagine Ms. B’s armchair-bound mother, or her controlling, abusive ex-husbands, engaging her
with disruptive attunement. (They were, no doubt, disruptive, but disruption is far from
disruptive attunement. Perhaps this suggests that disruption without attunement can trigger a
need to find refuge in being.)
However, despite the disruptive attunement I provided (or whatever may have triggered
Ms. B’s surge of activity), the sudden and exciting nature of her newfound doing seemed to be
more of a manic flight to health than a genuine discovery of a new relational pattern. It was not
instead she had swung from one pole to another. No new space was created. For when Ms. B
learned that she would soon be losing her mother, all of her movement collapsed back in on
itself. We might venture that she was reverting to the hypertrophied homeostatic relational style,
the being, that was all she had ever really known.
In short, we might say that Ms. B’s fragile sense of self was excessively focused on
being,to the detriment of all other modes of relating. She needed nearly constant homeostatic
attunement, if only from inanimate objects, to cobble together a sense of going-on-being. One
way that we might talk about certain depressions, then, is as a pathological excess of what
Winnicott spoke of as being.
Mr. D
Mr. D could be said to have presented hypertrophy, or pathological excess, on the other
end of the being-doing spectrum; his relating and his presentation were more exclusively focused
with doing. Mr. D’s hair was gray, but no other physical or behavioral characteristic belied his
age. He seemed like a much younger man, biceps, quadriceps, and all. He strode into the room
each week and sat himself firmly upon the couch, legs spread wide apart. He often kept his arms
crooked rakishly, maybe roguishly, behind his head, or used them when speaking to carve bold,
demonstrative strokes in the air. The strong physicality of his posture was accentuated by his
frequently wearing shorts, a t-shirt, and open-toed shoes, even in cold weather.
Mr. D liked to talk about ideas that excited him. The manic quality of this presentation
was reflected in his diagnosis of Bipolar Disorder, and in the medication he took for it. The ideas
that excited Mr. D included quantum mechanics and other aspects of physics (e.g., the optical
car going), or scenes from movies in which Gregory Peck and others acted heroic. Phallic
imagery was also a common source of material for Mr. D: the World Trade Center towers, the
obelisk in 2001: A Space Odyssey, and Big Ben all made frequent appearances in his
associations.
The memories that involved these phallic images often involved Mr. D’s father, to whom
Mr. D was very attached, and whom he idealized. Thus, stories about activities with his father –
e.g., his father pushing him on a swing, or teaching him how to sail or install a TV antenna on
the roof – could be included on the list of exciting ideas that Mr. D liked to talk about. Mr. D’s
mother, on the other hand, was so devalued in Mr. D’s mind that she almost ceased to exist for
him (or was annihilated by him). For example, Mr. D reported dreams which featured his father
as a central figure and in which his mother “did not exist.” He also reported that a college mentor
once asked him if his mother was still living, because he spoke so frequently of his father but
never mentioned his mother.
For my part, I found all this at first to be very enjoyable; I felt myself getting caught up in
the excitement with Mr. D. Though I tried to contain this countertransference, at least in my
outward relating, I began to relish the opportunity to make interpretations through the medium of
quantum mechanics, or of Gregory Peck’s heroic moments in racecars or submarines. Soon,
however, instead of leaning forward in my chair and gesticulating back at Mr. D when making an
interpretation, I found myself more and more leaning back, folding my hands in my lap, and
letting Mr. D do to his heart’s content.
Discussion. The case of Mr. D can also be read through the lens of Winnicott’s being,
what clinical relevance such a reading may hold. Like Ms. B, Mr. D’s relating occurred
primarily, seemingly almost exclusively, in just one of the three areas that Winnicott (1970)
described as an essential part “of the life of the human being” (p. 2). His hypertrophied focus
was on the area of doing, that is, with the area of “external life” that this paper has posited as the
substance of Winnicott’s doing.
Perhaps this hypertrophy reflected the relational patterns Mr. D had with his primary
caregivers as a child. His father seemed to provide almost exclusively disruptive attunement – or
those are, at least, the only sorts of memories Mr. D recalled of their relating. And neither his
father nor his mother seemed to provide much in the way of homeostatic attunement, that is, with
a sense that he was held and secure and that he need do nothing other than go-on-being. Mr. D’s
experience of receiving only disruptive attunement from his father and no other sort of
attunement from either parent may have contributed to his preoccupation with phallic imagery
and with doing. That is, perhaps the link between phallic imagery and doing isnot that these
concepts are intrinsically masculine, but that Mr. D associated both these concepts with his
father, the only caregiver who seemed to attune to him.
Whatever the case, Mr. D’s focus on doing had a countertransferential effect on me. The
reader will remember that the weight of Ms. B’s seemingly immobile presence – her staunch
determination simply to be – led me to seek out ways of engaging her more actively, of attuning
to her in a disruptive fashion. Mr. D’s fierce drive to do, on the other hand, soon led me to
respond by relating in a more laconic, homeostatic manner – that is, as I described above, leaning
Gradually, in response to this homeostatic attunement, Mr. D began to develop more of a
capacity to be with me, and with himself. He began, more and more, to pause and reflect on his
feelings about a story he might recount, rather than rushing into the intellectual theorizing or
philosophizing that was his wont. In short, he could be with how he felt, rather than rushing to do
something about it. Perhaps most excitingly, we began sometimes to play with what might be at
hand. That is, we could step back from Mr. D’s verbose, active storytelling to be in the moment –
and then we could move forward again, in a playful way: exploring possibilities, imagining or
even experimenting with new ways of relating or perceiving, all without definitive or necessary
conclusions.
In sum, we could say that Mr. D was focused on doing to the detriment of other modes of
relating. He would, indeed, almost invariably interact with the external world as a parent might
disruptively attune to a child: introducing new elements (e.g., his physics patent, or the
conspiracy theory about which he was so passionate), and manipulating physicality in novel,
exciting ways (e.g., stepping out to get the mail and walking a mile around the block, or
MacGyvering a solution to an automotive problem). One way that we might talk about certain
Chapter 3
Conclusion
In summary, reading these cases through Winnicott’s metonymy might lead us to
partially interpret the two patients’ narratives in the following way: Ms. B’s mother and her
numerous, abusive ex-husbands provided very little in the way of disruptive attunement, with its
correlate of doing. Instead, the paucity of attunement that Ms. B did receive seemed much more
unilaterally homeostatic. This could be said to have contributed to establishing a relational
pattern that she extended into the present with her staunch determination simply to be and not to
do. We might conjecture something similar about Mr. D’s early experiences. The only significant
positive interactions that Mr. D recalled were of disruptive attunement – of doing, of exciting,
physical engagement with his father and the outside world. He did not seem to receive or
internalize much homeostatic attunement. Perhaps this dynamic contributed to Mr. D’s periods
of manic doing, and his initial inability to be with himself or his experiences.
One might be tempted to read these cases along gender lines, like Winnicott originally
proposed. Such a reading might venture the shorthand descriptions of Ms. B had a
preponderance of female “object-relating,” and Mr. D a preponderance of male
“object-relating” (Winnicott, 1970, p. 81). However, I submit that this would be an inaccurate reading of
the situation, and an unfortunate one at that, because it would unnecessarily perpetuate
problematic sex- or gender stereotypes. Ms. B’s mother and Mr. D’s father did seem to attune in
Herzog’s (1984) observational studies found to be most common. However, Ms. B’s mother (or
other women in her life) could certainly have provided more disruptive attunement, fostering in
Ms. B the capacity to do as well as to be. And Mr. D’s father (or other men in his life) could
have related to his son with more homeostatic attunement, fostering in Mr. D more of a capacity
simply to be. In short, a person of any gender can relate in either homeostatic or disruptive ways;
it is a person’s manner of relating, not their gender, that can impact someone’s capacity for
being, doing, and play.
The effect of my interactions with Ms. B and Mr. D demonstrate this. It was surely not
my male sex or gender that facilitated Ms. B’s movement out from her self into the world. For
my work with Mr. D – as the same, cis-male clinician – facilitated his making the opposite sort
of shift that Ms. B did: slowing down instead of speeding up, moving inward instead of outward.
It must, then, have been (among other factors) something about the position from which I was
relating that induced these markedly different changes in Ms. B and Mr. D. Perhaps Ms. B’s
relational pattern seemed to shift as I responded to her homeostatic being with a disruptive
invitation to do. And perhaps Mr. D began, gradually, to do less and be more as I responded not
with the disruptive attunement that he pulled for but with the homeostatic attunement that he
longed for. Even more felicitously, perhaps my oscillating between both relational positions with
Mr. D contributed, over time, to his becoming more able to play with the innumerable ways in
which he could relate to himself and to the world.
The idea of a clinician oscillating between different relational positions is felicitously
sophistication than I might hope to achieve in this paper.3 So I will not say more about that
technical aspect. Instead, what I will submit is that exploring such oscillation through the lens of
Winnicott’s “being and doing”is valuable because doing so allows us to bring the concept of
play into the picture. When we see homeostatic attunement as fostering the stable, inner sense of
self that Winnicott spoke about as being (or as the “true self”), and disruptive attunement as
fostering the healthy engagement with alterity that he spoke about as doing, we locate the
relational styles of a clinician on either side of the critical domain of play.
The concept of play has been perhaps the richest source of clinical wisdom to come from
Winnicott’s oeuvre. It is safe to say that I need not elaborate much on this well-discussed topic.
Here then, is my brief discussion of the way in which I see Winnicott’s play as enriching our
discussion of the homeostatic being and disruptive doing between which clinicians may oscillate.
Final Thoughts on Play
At one point, Winnicott (1970) describes psychotherapy itself as “two people playing
together” (p. 38). In giving this description, he adds that “where playing is not possible then the
work done by the clinician is directed towards bringing the patient from a state of not being able
to play into a state of being able to play” (p. 38). If we accept this presupposition, the oscillation
that Akhtar and Bollas describe is, more than anything, a form of relating in which the clinician
3 For example, among other interesting points that these authors make, Bollas (1996) argues for preserving the
allegorical use of “mother” and “father,” instead of abstract terms such as “homeostatic” or “disruptive.” Regarding his use of these terms he states:
Am I not allegorizing where abstract terms would do us better? This may be so. But … if we think of the mother and the father we simultaneously evoke our own precise histories with these persons and their structures: shared in common among all people. So we are immediately part of our personal history and a universal order, as all of us have our mother and our father, and yet each of us participates in psychic orders that are properly listed under the name of the mother and
is trying to bring the patient into “a state of being able to play.” Winnicott’s work is replete with
discussion of how important this work can be.
In short, what may be so vital about play is that it is a space in which a person may
practice moving from being into doing and back again, without bearing the full weight of
overdetermined reality. Games of all sorts – from the “playing house” of toddlers to the
immersive role-playing games of adolescents and adults – seem to demonstrate this. Dreaming
can also be seen as a vital, playful, rehearsing function in this way. And, of course, the
psychoanalytic situation is vital in the same sense.
This discussion of a vital space [of playing, and of dreaming and analyzing etc.] between
a polarity [of being–doing] may sound familiar to many readers. It may call to mind the
discussion of finding thirds and deconstructing polarities/binaries that has been going on for over
a decade now (e.g., Aron & Starr, 2013; Benjamin, 2004; Ogden, 1994). There is much to
commend this perspective, and I submit that we might justifiably read this theory of being–
doing–play against such a contemporary, relational background. The necessary oscillation
between homeostatic empathy and disruptive interpretation takes on even more significance if
we read this oscillation as an essentially revolutionary (Marxist-Hegelian) one – that is, one in
which we are trying to find a synthesis between thesis and antithesis. Such a reading locates the
playfulness of psychoanalytic work as the radical, revolutionary agent (the synthesis between the
thesis of being and the antithesis of doing) that proponents of contemporary psychoanalysis
might hope it to be.
To move from the safety and security of being into the risk and the adventure of doing is
Akhtar (2000), Bollas (1996), and Benjamin (1988) all note, this kind of flexibility is required of
us as clinicians, if we are to help patients further develop the liberating, revolutionary capacity
for thirdness. So in returning to the Winnicottian metonymy whence this exploration began, we
are now prepared to say that “…there can be no do before be,” but being and doing alone do not
comprise the full “life of a human being” (Winnicott, 1970, p. 2; Winnicott & Winnicott, 1986,
p. 25). Playing is the vital, third space between being and doing, from which synthesis and
References
Akhtar, S. (2000). From schisms through synthesis to informed oscillation: An attempt at
integrating some diverse aspects of psychoanalytic technique. Psychoanalytic Quarterly
69, 265-288.
Aron, L., & Starr, K. (2013). A psychotherapy for the people: Toward a progressive
psychoanalysis. New York, NY: Routledge.
Benjamin, J. (1988). The bonds of love: Psychoanalysis, feminism and the problem of
domination. New York, NY: Pantheon.
Benjamin, J. (2004). Beyond doer and done to: An intersubjective view of thirdness.
Psychoanalytic Quarterly, 73, 5-46.
Bollas, C. (1996). Figures and their functions: On the oedipal structure of a psychoanalysis.
Psychoanalytic Quarterly, 65, 1-20.
Butler. (1995). Melancholy gender—Refused identification. Psychoanalytic Dialogues, 5,
165-180.
Gerson, G. (2004). Winnicott, participation, and gender. Feminism and Psychology, 14, 561-581.
Green. (2010). Sources and vicissitudes of being in D. W. Winnicott's work. Psychoanalytic
Quarterly, 79(1), 11-35.
Mitchell, S. (1988). Relational concepts in psychoanalysis: An integration. Cambridge, MA:
Harvard University Press.
Mitchell, S. (1991). Contemporary perspectives on self: Toward an integration. Psychoanalytic
Dialogues,1, 121-147.
Ogden, T. (1994). The analytic third: Working with intersubjective clinical facts. The
International Journal of Psychoanalysis, 75, 3-19.
Phillips. (1995). Keeping it moving: Commentary on Judith Butler’s “Melancholy gender—
Refused identification.” Psychoanalytic Dialogues, 165-180.
Winnicott, D. (1965). The maturational process and the facilitating environment. London, UK:
Hogarth Press.
Winnicott, D. (1970). Playing and reality. New York, NY: Basic Books.
Winnicott, D., & Winnicott, C. (1986). Home is where we start from: Essays by a psychoanalyst.
Appendix A
Curriculum Vitae
NATHAN HASKELL
288 Barre St. #2, Montpelier, VT 05602 (503) 957-7974
E
DUCATIONPsy.D., Clinical Psychology (current GPA: 3.96) Anticipated: May 2017
George Fox University – APA Accredited –
M.A., Clinical Psychology (GPA: 3.98) May 2014
George Fox University – APA Accredited –
B.A., English Literature, magna cum laude(GPA: 3.89) June2010
University of Portland
Outstanding English Major Award, Class of 2010
S
UPERVISEDC
LINICALE
XPERIENCEPre-Doctoral Internship Aug. 2016 – Present
Norwich University, Northfield, VT
• Provided individual psychotherapy to students, faculty, and staff
• Responded to after-hours crisis calls and evaluated for suicidal/homicidal risk • Coordinated care with infirmary, Student Affairs office, Academic
Achievement Center, International Students Center, and Corps of Cadets • Managed scheduling of individual caseload
• Conducted community outreach programs
• Wrote weekly progress notes and crisis response notes
Practicum III – (Inpatient Psychiatric Hospital) Sep. 2015 – June 2016
Oregon State Hospital, Salem, OR
• Provided individual and group psychotherapy
• Provided psychological assessment, including Violence Risk Assessments and Short-Term Assessments of Risk and Treatability
• Participated in multidisciplinary case conferences with psychiatrists, nursing managers, case workers, clinical social workers, and other psychologists • Coordinated care with Sex Offender Treatment Program team and Psychiatric
Security Review Board
• Wrote weekly progress notes; reviewed notes and records from multidisciplinary team
• Conceptualized and presented cases for individual and group supervision
Practicum II – (College Counseling Center) Aug.2014 – May 2015
Warner Pacific College, Portland, OR
• Provided individual psychotherapy and academic/career counseling • Provided psychological assessment, wrote reports and diagnoses, and
provided feedback to individuals
• Coordinated care with academic mentoring programs and residence life office • Engaged in community outreach and academic mentoring
• Conducted intake assessments; formulated diagnoses and treatment plans • Wrote intake reports and weekly progress notes
• Conceptualized and presented cases for individual and group supervision
Practicum I – (Community Mental Health Center) Aug.2013 – Present
George Fox Behavioral Health Clinic, Newberg, OR
• Provided individual, group, and couples psychotherapy
• Provided psychological assessment, wrote reports and diagnoses, and provided feedback to individuals
• Coordinated care with medical clinics, court systems, and insurance companies
• Managed scheduling of individual caseload in conjunction with clinic waitlist • Conducted intake assessments; formulated diagnoses and treatment plans • Wrote intake reports, weekly progress notes, and termination summaries • Conceptualized and presented cases for individual and group supervision, with
video and audio review of sessions as part of supervision
Dream-Analysis Group Therapist Mar. – May 2015
George Fox University Psy.D. program, Newberg, OR
• Organized and facilitated a weekly dream-analysis group
Apr. – May 2012
Bibliotherapy Group Therapist Feb. – Apr. 2013
George Fox Behavioral Health Clinic, Newberg, OR
• Organized and co-facilitated a bibliotherapy/process group
Chronic Pain Group Therapist Nov. – Dec. 2013
George Fox Behavioral Health Clinic, Newberg, OR
• Organized and co-facilitated a psychoeducational/process group for individuals with chronic pain
Depression Group Supervisor Oct. – Nov. 2013
Nedley Depression Recovery Program, Newberg, OR • Supervised depression group facilitators
• Received supervision of supervision from licensed clinical psychologist
Depression Group Facilitator Oct. – Nov. 2012
Nedley Depression Recovery Program, Newberg, OR
• Co-facilitated a psychoeducational depression management group •
Pre-Practicum Therapist Aug. – May 2012
George Fox University, Psy.D. program, Newberg, OR
• Provided individual psychotherapy to university undergraduates
• Conducted intake assessments; formulated diagnoses and treatment plans • Wrote intake reports, weekly progress notes, and termination summaries • Conceptualized and presented cases for individual and group supervision
Pre-Practicum Therapist Mar. – Apr. 2012
Ateneo de Manila University, Dept. of Counseling Psychology, Manila, Philippines • Provided individual psychotherapy to a 29-year-old Filipino male • Developed treatment plan; wrote case report and termination summary
R
ELATEDC
LINICAL&
A
CADEMICE
XPERIENCEPanel Discussant Anticipated: Apr. 2016
• Invited to serve as a discussant on a live-supervision panel at 2016 Spring Meeting of APA Division 39 (Division of Psychoanalysis)
American Psychological Association Scholar Feb. 2015 – June 2016
APA Division 39 (Division of Psychoanalysis), Multicultural Committee
• Received monthly mentoring from local psychoanalytic psychotherapist • Received $500 grant to attend 2015 Spring Meeting of APA Div. 39 • Received 12-month subscription to Psychoanalytic Electronic Publishing
(PEP-Web) journal archive
Graduate-Level Instructor Aug. 2015
“The Contemporary Psychoanalytic Perspective” Alliance Graduate School, Manila, Philippines
• Organized course content (based on psychoanalytic texts and journal articles) and developed syllabus
• Lectured, facilitated discussion, and led activities to promote engagement • Graded assignments and papers
Conference Presenter Apr. 2015
Christian Association of Psychological Studies, International Conference • Presented modified version of dissertation material
Program Consultant Jan. 2015 – May 2016
Clinical Advisory Committee, George Fox Univ. Psy.D. program
• Provided consultation about clinical training and didactic opportunities • Advocated for the student body regarding clinical and academic concerns
Program Coordinator Oct. 2014 – May 2016
Doctoral Psychology Student Seminar Series
• Developed and co-coordinated an interscholastic series of seminars for doctoral psychology students, covering a wide range of relevant issues
Diversity Leadership Consultant Sep. 2014 – May 2016
Ubuntu Leadership Group, George Fox Univ. Psy.D. program
• Participated by invitation in a group that met to discuss leadership and other issues for psychologists of color
Peer Supervisor Sep. 2015 – May 2016
Clinical Foundations course, George Fox Univ. Psy.D. program
• Provided group and individual supervision to first-year Psy.D. students • Reviewed video recordings of students’ clinical work
• Provided feedback, in-vivo and on written assignments
Peer Supervisor
Jan. – May 2015
Psychodynamic Psychotherapycourse, George Fox Univ. Psy.D. program • Supervised second-year Psy.D. students in clinical lab group • Facilitated discussion of students’ clinical material
• Facilitated group process
Teaching Assistant
- Contemporary Psychoanalytic Therapy Fall 2015 - Clinical Foundations Fall 2015
- Multicultural Psychotherapy Spring 2015 - Psychodynamic Psychotherapy Spring 2016; Fall 2014
- Psychology & Culture (undergraduate course) Fall 2014
- Integrative Approaches to Psychology & Psychotherapy Spring 2014
- Ethics for Psychologists Fall 2013 • Developed and delivered lecture material
• Met and corresponded with students to provide assistance and clarification • Graded assignments, mid-terms, and final exams
• Assisted professors with online grading system
Grant-Funded Researcher Jul. 2014
Richter Scholars Program, Manila, Philippines
• Gathered data for a self-proposed research project (award: $1,676)
Volunteer Therapist / Staff Member June – Dec. 2012
LifeChange Recovery Center, Manila, Philippines
(Residential treatment facility for patients with psychiatric disorders or addictions)
• Provided individual psychotherapy to patients (for disorders including schizophrenia, bipolar disorder, and methamphetamine addiction) • Participated as milieu therapist; co-facilitated group-activities • Wrote case reports and evaluated patients for release
S
ELECTEDT
RAININGS&
W
ORKSHOPSBowen Family Systems Theory Symposium March 2017
Burlington, VT
Quarterly Psychological Case Conferences (“Clinical Moments”) Jan. 2013 – May 2016
American Psychological Association Division 39 Spring Meeting April 2016
Atlanta, GA
San Francisco, CA April 2015
Seminar Series on Michael Eigen’s The Psychotic Core Sep. – Dec. 2015
Office of Robin Bagai, Psy.D.
Fundamentals of Psychoanalytic Psychotherapy Sep. – Jun. 2014
Oregon Psychoanalytic Center
DSM-5: Essential Changes in Form & Function Jan. 2014
Jeri Turgesen, Psy.D.
Mary Peterson, Ph.D., ABPP
NW Assessment Conference May 2013
Paul Green, Ph.D. Mark Bondi, Ph.D.
Psychoanalytic Treatment Seminar Feb. – May 2013
Oregon Psychoanalytic Center
Motivational Interviewing Workshop Jan. 2013
Michael J. Fulop, Psy.D.
V
OLUNTEERE
XPERIENCES.U.N. (Schools Uniting Neighborhoods) Tutor Jan. – June 2010
Roosevelt High School, Portland, OR
• Provided after-school tutoring and mentorship to students with academic, behavioral, and/or psychosocial difficulties.
“Lunch Buddy” Sep. 2009 – June 2010
Clarendon-Portsmouth Elementary, Portland, OR
• Informally mentored children with behavioral issues.
S.M.A.R.T. (Start Making A Reader Today) Reader Sep. 2008 – June 2009
Clarendon-Portsmouth Elementary, Portland, OR
A
DDITIONALL
ANGUAGESS
POKENFluent: French
Intermediate fluency: Spanish
Receptive skills only: Filipino, German
R
EFERENCESMelvin Miller, Ph.D.
(Internship Training Director and Clinical Supervisor) Norwich University Counseling & Psychological Services 158 Harmon Dr., Northfield, VT 05663
(802) 485-2126 [email protected]
Polly Young-Eisendrath, Ph.D.
(Clinical Supervisor)
Norwich University Counseling & Psychological Services 158 Harmon Dr., Northfield, VT 05663
(802) 223-6223 [email protected]
Nancy Thurston, Psy.D., ABPP
(Faculty Mentor and Clinical Supervisor) George Fox University
414 N. Meridian St. #V104, Newberg, OR 97132 (503) 554-2378
